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KMID : 0390619980060010038
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Journal of Cardiovascular Ultrasound
1998 Volume.6 No. 1 p.38 ~ p.46
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Relationship of Ambulatory Blood Pressure Monitoring Data to Echocardiographic Findings in Hemodialysis Patients
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Cho Jin-Man
Kang Heung-Sun
Lee Tae-Won
Choue Chung-Whee
Kim Kwon-Sam
Song Jung-Sang
Bae Jong-Hoa
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Abstract
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Background : Mortality and morbidity of the patients with chronic renal failure frequently related to cardiovascular disease, especially to Hypertension. The present study was performed to assess the value of ambulatory blood pressure(ABP) monitoring in determining the adequacy of blood pressure(BP) control, and its relationship to echocardiographic findings in hemodialysis(HD) patients.
Subject & Methods : Twenty adult patients who had been on regular hemodialysis treatment for median duration of 23 months were studied. 24 hour ABP monitoring was performed using a non-invasive ABP monitor. All of the study population were non diabetic. Casual BP(CBP) was defined as the average of two measurements obtained at two HD sessions, one preceding and the one following the ABP recordings, and was calculated for both the predialysis and postdialysis phases. Cardiac echocardiography was performed in each patient to determine interventricular septal thickness(IVS), left ventricular posterior wall thickness(LVPW), left ventricular fractional shortening(FS), and left ventricular mass index(LVMI).
Results :
1) 17(85%) of patients showed left ventricular hypertrophy in echocardiography. LVMI was positively correlated with systolic BP load(r=0.45, rho<0.05). But, the correlation between LVMI and diastolic BP load was not statistically significant.
2) IVS showed positive correlation to 24hr systolic and diastolic blood pressure load, but LVPW did not show correlation to any subset of 24h-ABP monitoring data except daytime systolic BP load.
3) LVMI showed correlation to day-time systolic BP load, but it did not show correlation to night-time BP load.
4) Casual BP did not show correlation to echocardiographic data.
Conclusions : These results suggest that 24hr ABP monitoring is more useful and accurate method than CBP to determine the degree of LVH and control of blood pressure in hemodialysis patients with hypertension.
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KEYWORD
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Ambulatory blood pressure monitoring, Hemodialysis, Chronic renal failure
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